Reflections on an Anniversary

The 17^th of this month is the anniversary of when I started at Lien Animal Clinic.  I have been at Lien for 24 years. I have practiced veterinary medicine now for half of my life. You’d think I’d get it right by now and stop calling it practice. J

I graduated from WSU in 1989, a few months after my 24^th birthday. I was very young and desperately wanted to be good at this. I accepted an internship in Rochester, NY at a group of seven hospitals to pursue that goal. I worked the hours. I saw the emergencies all night. I lived and breathed the profession in lieu of all else. At some point, I looked up and it was going well. There were teachers among the doctors, there were staff who helped me learn and there were clients that had faith in me. I walked out of the experience fundamentally changed from when I had walked in. I drove away in my little yellow truck with Dr. Fritzler (then she was just Beth), our two dogs, Camille and Cloie, and “New York is Not My Home” by Jim Croce queued up in my cassette player. We took a month to meander back across the country.  There’s a small motel in Illinois whose baseboards were never the same; Camille was just a puppy at the time and may have needed something to chew on.

            Beth still had a year of veterinary school left in Pullman. I moved back to Seattle to work for a year and then we planned to reconsider where we wanted to live. I interviewed at seven clinics. I remember being annoyed at trying to find parking at Lien when I went to interview. Completion of an internship played well and I had offers at all of the practices. Some of them were much bigger. Most of them were nicer facilities.  Anyone who knew the old Lien clinic knows that it was not a place of fantasies. My first desk was in the treatment room next to the only treatment table. Surgery had no windows. The building in general was very dark. The waiting room paneling is somewhere in a museum to the 1970’s next to an avocado colored refrigerator. But, there was something about Dr. King. Larry was genuine. You trusted him instantly and you knew he cared. I liked and trusted his wife Connie as well.  I chose them over glitzier surroundings and I can look back on that decision as one of the best gut decisions I ever made. 

So, on September 17^th, 1990 I started working at Lien. It was just Larry and I. He had been by himself for many years.   I still don’t know how he did that. We were busy. I saw tons of cases and we helped each other. We did good work. He and I shared emergency calls 24/7 and it was daunting. When that first year was up, I stayed. I liked my job, the clients and the people I worked with.  Beth came over to the west side after graduation. We moved off and on for several years trying to stay close to both our jobs.  We got married in 1992 and moved to Vashon Island in 1994. On the island, we could have our horses and we planned on raising a family. Our first son, Geoffrey, was born in 1995 and Beth joined Lien part time in 1996. She joined the clinic with the intent that we would eventually buy it from Larry and Connie.

So Beth and I started practicing together 2 days a week in 1996 and it was fantastic.  It has been a positive shared experience. Even in the small confines of that building, it was never too much togetherness.  We each had our own patients and surgeries but we always had each others backs. We could always relate to each others struggles and triumphs. In December of 1997 our daughter, Aubrey, was born. We bought the clinic in February of 1999.

Ownership has brought an enormous set of challenges and required the development of a very different array of skills. Our youngest son, Nick, was born in 2002. While the struggles have been great, so too have the rewards. We were able to replace the old building in 2009.  There are now seven doctors working at the clinic. 

            I grew up here and I have watched the clinic emerge into the bustling entity it has become.  I watched the profession grow and change.  I also have seen my kids grow up here.  Nick wants to be a veterinarian.  Aubrey works now as a receptionist.  Geoffrey just applied to veterinary school at WSU. 

Sometimes one ponders what they have done with all the time.  For me, at least during insightful moments, I can see the years weaved into all that surrounds me.

Timothy R Kraabel, DVM, DABVP (Canine/Feline Practice)

Outreach Chairman, American Board of VeterinaryPractitioners

How old is my pet?

While we all know that pets age faster than their owners, it is not always clear how much.  Conventional wisdom has typically estimated pet aging at about 7 years per year of human life.  This rule-of-thumb becomes obviously inadequate for cats and large dogs.

Many factors come into play in determining lifespan.  Species, breed, size, heredity, diet, spay/neuter status, veterinary care, and lifestyle (such as, indoor or outdoor for cats) all factor into length of life.  In dogs in particular, size matters.  Big dogs don't live as long.  Small dogs may not be "senior" until 10-12 years old, while giant breeds may be "senior" at 5 years old.  Routine physical examinations, proper nutrition,  preventative care, and appropriate senior care are the best ways to tip the lifespan balance in our favor.

The chart below is a rough guide to consider your pets real age.

Timothy R Kraabel, DVM, DABVP (Canine/Feline Practice)
Outreach Chairman,  American Board of VeterinaryPractitioners

Feline Inappropriate Urination – Part II: Please Make It Stop

        Once we've considered who is peeing in the heater vents and we have asked ourselves why they are doing it, we can  tackle the what, where, and how of  solving the problem.  Treatment has to be individualized to each situation and cat, or cats.  Of course, we may not discover the  exact reason for the inappropriate urination  so a multimodal approach is best in most cases.   

1.      The soiled environment.  The urine-soiled area needs to be thoroughly cleaned with an enzymatic cleaner, such as Nature’s Miracle, to  eliminate future visits.  The area also may need to be closed off from the offending cat.  Plastic totes, double sided tape, foil, furniture placement, potted plants, and invisible fencing may all be  used to prevent access.  If the specific area is not easily identified, a black light can help locate soiled spots.

2.      The litter box.  Make sure the box is roomy and comfy for everyone who needs it.  Obese cats and large cats need more space.  As a rule, sides, liners and covers are bad.  Kittens, older cats and the infirm may have a hard time negotiating sides on the box.  Liners are just annoying when kitty   tries to scratch around and cover feces and urine.  Box covers trap smells and block kitty’s view of intruding other cats.  As a cat, one typically likes a 360-degree view while eliminating.

3.      The box placement and number of boxes.  As stated before, one box per cat, plus one, is recommended; and make sure that there is a box on each level of the house.  Put the boxes in well lit, quiet areas away from food and water but close to where the cats spend the majority of their time.

4.      Pick the right litter.  Most cats prefer fine-textured, unscented litter, several inches deep.  If in doubt, try litter box samplers.  Put out several different boxes with several different types of litter - clay, sand, paper litter, or even soil.  Let your cat cast its vote with urine and go with the demonstrated preference. 

5.      Cleanliness.  As a basic rule of thumb, scoop the box daily.  This may not be enough in multi-cat households if one box is particularly popular.  If you ask the cats, they would each want a personal litter box valet that kept the other cats out of the area, looked away while they used the box, handed them a kitty treat as they exited the box, and then removed any offending material immediately.  Always empty and thoroughly clean boxes every 1-2 weeks, depending on use.

6.      Avoid punishment.  Never physically punish your cat for inappropriate elimination.  Not only  is that ineffective, but it quite likely will make things worse.  Punishment will create more anxiety and cats will not connect the crime to the punishment.

7.      Medical treatment.  If your veterinarian uncovers medical issues such as drinking more water or urinary tract infection, treatment plans will need to be determined and implemented.

8.      Anxiety and urine spraying.  Anti-anxiety medications may be utilized.  Drugs such as Prozac, amitryptylline, and busprinone can be  prescribed.  Medication use would need to be discussed with your cat’s doctor.  Such therapy is often life-long, although withdrawal of medication may be considered after long periods of good behavior.  We may also use pheromone sprays, such as Feliway, to promote positive feelings in the cats when they enter the area involved.

        Feline inappropriate elimination is a frustratingly common problem.  It is imperative to act quickly when it happens.  The longer such a problem goes on, the more difficult it may be to correct.  Once the offending cat is identified, take him or her to your veterinarian for a thorough physical examination and have a discussion about your options.  Once medical disease is ruled out, together we may tackle the many issues discussed here and formulate our best plan.  With thought, perseverance, environmental manipulation and appropriate medications, we can  often help.

Timothy R Kraabel, DVM, DABVP (Canine/Feline Practice)
Outreach Chairman, American Board of VeterinaryPractitioners